Kathmandu, 2 April 2018.
"Go everywhere and announce the Message
of God’s good news." Mark 16:15
It was a glorious March morning as I cycled along the still-quiet streets to Patan Hospital. Having sent the boys off on their new 7am school bus, I was hoping to get an early start to a busy day in my new role of helping the hospital develop nutrition services for patients. The air was filled with birdsong and bright sunshine that quickly dismissed the early morning chill, and the sense of spring in the air was palpable. So strange, I thought, to be surrounded by such light and hope when a shadow had just loomed over our heads. Arriving at the hospital, I was soon busy supervising the preparation of nutrition supplements in the kitchen and checking individual patients who were to receive them on the wards. Nevertheless thoughts kept popping into my head as to what the coming weeks, or even months, might hold for us.
For years, Mark had been aware of a brown patch on his left forearm, often exposed to sun while hanging it out car windows. Recently he had wondered if it was changing colour and one morning in early March decided it had gone dusky red. The next day, between two busy clinics, he had Chief of Surgery Dr. Sanjay remove it, leaving a seven-stitch incision. Dr. Sanjay recommended that the specimen be sent to a private pathologist whom he trusted. Six days later the pathologist phoned Mark with her findings: ‘Lentigo Maligna Melanoma.’ She invited Mark to her office to discuss his report in detail, including the fact that the margins cut around the lesion were not sufficient to be
considered safe. She advised that he would definitely need to have it re-excised, and that he needed further specialised tests not available in Nepal to determine the depth and degree of the cancer. The doctor had done her pathology training in Chicago and later at Johns Hopkins University, and was a U.S. board-certified pathologist. Her English was polished and her manner professional and caring. Together, she and Mark packed his microscope slides and biopsy specimens into a box for shipping overseas.
The next couple of weeks were a whirl of e-mails and arrangements. Dermatologists have long waiting-lists in the US and it seemed that health facilities in Thailand would not be sufficiently experienced with melanoma. Sending enquiries to U.S. medical colleagues, a long-time friend since college days connected Mark with his friend Dr. Linda Wang, an outstanding dermatologist in Baltimore and an authority on skin cancers. Dr. Wang immediately emailed Mark about his case and reviewed his pathology report, agreeing that he needed to send the specimens to her office as soon as possible and come to the US himself about a week later. A four-day visit to Kathmandu by Jim and Marilyn Simons gave us the chance to rush the box of biopsy specimens back to New York for mailing on to Baltimore. We researched air tickets and booked a flexible ticket for Mark to leave on the night of Easter Sunday, with free changes to his return date. The one silver lining to the cloud was that Mark would fly in and out of Philadelphia, and have the chance to visit his mother at the same time.
The increased numbers of doctors on the medical team meant that there was no difficulty for Mark to take the necessary leave. On the other hand, my work as the sole dietitian on a part-time basis was peaking towards a major presentation to senior doctors and nurses about the importance of developing nutritional services as part of patient care. More supervision was required on the home front too as the boys broke from school for Easter holidays. Benjamin spent a good amount of time working on basketball skills, while Zachary tucked into some serious study towards his international exams that take place in May.
The boys were briefly startled by Mark's diagnosis but understood that we were working to deal with it. We told close friends about the situation and many, including Benjamin's classmates, assured us of their daily prayers. A week later, our Nepali church was conducting a ‘Healing Program' to which we had invited
a friend with lung cancer along with her husband.